Group finds rate of 1 fatality a day in Arkansas, Mississippi

A new study by an advocacy group says almost 13 working-age Tennesseans die each week due to lack of health insurance, and more than 1 person dies each day in Arkansas and Mississippi for the same reason.

The Families USA study notes that the uninsured often go without necessary care until it's too late.

"The problem with this study is that it had to be done," said Dr. David Mirvis, a University of Tennessee Health Science Center professor of preventive medicine. "We've known this for years, that it costs lives, and the numbers have gone up, not down. There are lots of excuses, but people are dying."

But Dr. Cyril Chang, director of the University of Memphis' Methodist Le Bonheur Center for Healthcare Economics, notes that just providing health insurance might not be the best way to save these lives.

"In Tennessee, there are 3,103,000 adults between ages 25-64 and 18.3 percent (or 567,849) of these do not have insurance," he said in an e-mail interview. "The Family USA's report says that 660 of these adults died in 2006 because of lack of health insurance.

"If we insured all of these uninsured adults at the low estimate of $5,000 per adult, the total cost would be $2.84 billion per year. That's a whopping $4.3 million per life saved. We can surely save more lives tackling other causes of death -- like smoking, excessive drinking and living an unhealthy lifestyle."

Mirvis notes that those with insurance are already paying more than half the cost of care for people without insurance.

"The other thing is, having health insurance not only saves lives, it improves quality of life, makes people more productive," Mirvis said. "He underestimates severely the impact of not having insurance. It's kids who can't go to school because they're sick, so then they can't get jobs, because they're not educated. It's companies that move into Tennessee and can't find an educated workforce."

"The majority of Tennesseans would tell you the people who got kicked off TennCare were bums and derelicts," Morris said. "That's not my experience. We had a convenience-store clerk come in here. Her right leg had been amputated some time ago, but on the day she got dropped from TennCare, she fell and tore up the prosthetic leg and couldn't afford to replace it. But she had to work, so at the end of the day, it took her two hours to close her store, because she was hopping around on one leg mopping the floor."

Mirvis and Morris, whose agency serves about 50,000 uninsured people a year, agree that society would get a bigger bang for the buck if it paid more attention to preventive care and healthy lifestyle changes.

But they also think health insurance reform is a good idea -- albeit a remote possibility.

"It has virtually zero chance of being implemented now," Morris said. "There's so much inertia in the system. What I think is that nothing will change until the Fortune 500 companies care enough to say something has to change. Unfortunately, the Fortune 500 companies are going the opposite direction."

Mirvis said that inertia comes from the vested interests not only of from the health care and insurance industry, but also of the majority who have health coverage and fear its loss in a reform process.

"It's going to take somebody like a Kennedy, when he said, 'We are going to the moon,'" Mirvis said. "He didn't say, 'We're going half-way to the moon.'

"We need somebody who'll say, 'What we want is appropriate health care for everybody in the nation,' and then we will have taken a huge step forward. If we set that as the ultimate goal, just as Kennedy did with the moon, we'll do it."

Chang's U of M colleague, Dr. Albert Okunade, First Tennessee professor of economics, said, "Combining personal responsibility with government provision of a universal access to a defined set of basic disease prevention and medical care is likely to cut U.S. premature deaths significantly."

Gary Gunderson, Methodist Le Bonheur Healthcare senior vice president, said his organization tries to meet the needs of uninsured people through a Congregational Health Network.